Shiha Gamal, Alswat Khalid, Al Khatry Maryam, Sharara Ala I, Örmeci Necati, Waked Imam, Benazzouz Mustapha, Al-Ali Fuad, Hamed Abd Elkhalek, Hamoudi Waseem, Attia Dina, Derbala Moutaz, Sharaf-Eldin Mohamed, Al-Busafi Said A, Zaky Samy, Bamakhrama Khaled, Ibrahim Nazir, Ajlouni Yousef, Sabbah Meriam, Salama Mohsen, Anushiravani Amir, Afredj Nawel, Barakat Salma, Hashim Almoutaz, Fouad Yasser, Soliman Reham
Egyptian Liver Research Institute and Hospital, Mansoura, Egypt; Hepatology and Gastroenterology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Lancet Gastroenterol Hepatol. 2021 Jan;6(1):57-64. doi: 10.1016/S2468-1253(20)30213-2. Epub 2020 Nov 9.
With the increasing prevalence of obesity and type 2 diabetes, fatty liver disease associated with metabolic dysfunction is a global health problem, especially because it is one of the earliest consequences of obesity and it precedes diabetes development. Fatty liver disease associated with metabolic dysfunction is of particular concern in the Middle East and north Africa, where its prevalence is greater than that in the rest of the world. Despite the magnitude of the problem, no regional guidelines have been developed to address this disease. This Review describes suggestions of redefining fatty liver disease associated with metabolic dysfunction, including its terminology and criteria for diagnosis. Experts have raised serious concerns on the current nomenclature, which labels the disease as non-alcoholic fatty liver disease (NAFLD), and its diagnostic criteria. The panel reached a consensus that the disease should be renamed as metabolic-associated fatty liver disease (MAFLD) and that the disease should be diagnosed by positive criteria. The aim is now to work with authorities across the region to implement these proposed changes and reflect them in health-care policy and to improve health care for patients in this region.
随着肥胖症和2型糖尿病患病率的不断上升,与代谢功能障碍相关的脂肪肝疾病已成为一个全球性的健康问题,特别是因为它是肥胖症最早出现的后果之一,且早于糖尿病的发展。与代谢功能障碍相关的脂肪肝疾病在中东和北非地区尤为令人担忧,该地区的患病率高于世界其他地区。尽管这一问题严重,但尚未制定区域指南来应对这种疾病。本综述描述了重新定义与代谢功能障碍相关的脂肪肝疾病的建议,包括其术语和诊断标准。专家们对目前将该疾病标记为非酒精性脂肪性肝病(NAFLD)的命名法及其诊断标准提出了严重关切。专家小组达成共识,该疾病应重新命名为代谢相关脂肪性肝病(MAFLD),并应通过阳性标准进行诊断。目前的目标是与该地区各地的当局合作,实施这些提议的更改,并将其反映在医疗保健政策中,以改善该地区患者的医疗保健。